PURPOSE: The aim of this study was to determine whether liver resection treated by using laparoscopy is equally safe for patients who have benign liver mass, hepatolithiasis, hepatocellular carcinoma (HCC), or metastatic liver cancer. METHODS: We performed our study in 32 patients with the following conditions: 17 patients with IHD stones, 7 with HCC, 1 with cholangiocarcinoma, and 7 patients who had colon cancer with liver metastasis. On a retrospective bases, these patients were investigated for clinical history, type of operation, time for the operation, hospital stay, and post operative complications. RESULTS: The target age range was from 37 to 80 years and the mean age was 61.2 years old. The percentage of patients over 60 years old was 68.7%. According to their past history, 8 patients had experienced an upper abdominal operation. In our study there were 9 cases of left hepatectomy (28.1%), 9 cases of left lateral segmentectomy (28.1%), 2 cases of sectionectomy, and 12 cases of wedgeresection. The average operation time was 364+/-148 mins, the average bleeding amount was 417 cc, and the average hospital stay was 13.2 days. There were 8 cases (25%) of postoperative complications developed (2 bile leak, 1 intrabdominal abscess, 1 acute renal failure, 2 wound infection). All cases were improved with conservative management. And there was one case of remnant IHD stone, which had surgical treat and one patient had peritoneal carcinomatosis, who had laparoscopic liver resection for HCC. CONCLUSION: Our study showed that laparoscopic liver resection has advantages; it is less painful, causes a small operative scar, a the short period of hospital stay and has cosmetic benefits. In the future, laparoscopic liver resection could be an important option for the treatment of hepatolithiasis and HCC through improved surgical instrument and skill of operation.
Abscess ; Acute Kidney Injury ; Bile ; Carcinoma ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Cicatrix ; Colonic Neoplasms ; Cosmetics ; Hemorrhage ; Hepatectomy ; Humans ; Laparoscopy ; Length of Stay ; Liver ; Mastectomy, Segmental ; Neoplasm Metastasis ; Postoperative Complications ; Retrospective Studies ; Surgical Instruments

Meningioma is relatively common, benign, and extra-axial tumor accounting for about 20% of primary brain and spinal cord tumors. The World Health Organization (WHO) classified these tumors into Grade I (benign), Grade II (atypical), and Grade III (anaplastic) meningioma. Grade I meningioma which is slowly growing tumor and have some rare subtypes. Among them, metaplastic subtype is defined as a tumor containing focal or widespread mesenchymal components including osseous, cartilaginous, lipomatous, myxoid or xanthomatous tissue, singly or in combinations. We report a rare metaplastic meningioma overspreading nearly whole cerebral convexity from main extra-axial tumor bulk in the parietal lobe.
Brain ; Brain Neoplasms ; Meningioma* ; Parietal Lobe ; Pathology ; Spinal Cord Neoplasms ; World Health Organization

PURPOSE: To evaluate the biomechanical results according to various anterior spinal fixation methodology in the treatment of thoracolumbar spine fracture. MATERIALS AND METHODS: The comparative analysis of fixation method was evaluated by three dimensional finite element model using the 1 mm reconstruction image of CT. Authors evaluated the flexion, extension, lateral bending, torsional stresses with 12 fixation methods for the compression and burst fracture. RESULTS: In biomechanical analysis, stiffness of body-fixation device was more stable in two-rod system in compression fracture and was stable in one-rod, two-rod system in burst fracture, but two-rod system was showed over-increase of stiffness. CONCLUSION: Authors recommend the usage of two-rod system in anterior fixation only and anterior one-rod system in anterior-posterior fixation.
Fractures, Compression ; Methods ; Spine*

OBJECTIVES: The objective of this study was to investigate the relationship between psychological distress and pain in cancer patients. METHODS: 249 patients with cancer who visited National Health Insurance Service Ilsan Hospital between April 2013 and March 2014 were evaluated with National Cancer Center Psychological Symptom Inventory(NCC-PSI) which consisted of Modified Distress Thermometer(MDT) and Modified Impact Thermometer(MIT). Each scale was divided into 3 subscales targeting separate symptoms: insomnia, anxiety, and depression. Psychological distress was defined as positive for those who scored above the cutoff values in at least one of all six subscales. The Numeric Rating Scale for Pain(NRS-Pain) was used to assess the subjective severity of pain. Logistic regression was performed to investigate the association between psychological distress and pain. RESULTS: Univariate logistic regression analysis showed that pain, gender, compliance, and two subscale scores of Hospital Anxiety and Depression Scale(HADS) were significantly associated with psychological distress. Multivariate logistic regression analysis showed that pain and HADS anxiety subscale score maintained a statistically significant association with psychological distress adjusted for variables including age, gender, years of education, Eastern Cooperative Oncology Group performance status, cancer stage, Charlson Comorbidity Index, compliance, and HADS depression subscale score. One point increase in pain was 1.31 times more likely to cause psychological distress. In secondary analysis, pain was significantly associated with all subscales of NCC-PSI, except MIT-anxiety subscale. CONCLUSIONS: This study suggests that NCC-PSI, a screening tool for psychological distress, reflects pain. We recommend that physicians who treat cancer patients consider the examination of psychological distress which provides comprehensive evaluation of various factors regarding quality of life.
Anxiety ; Comorbidity ; Compliance ; Depression ; Education ; Humans ; Logistic Models ; Mass Screening* ; National Health Programs ; Quality of Life ; Sleep Initiation and Maintenance Disorders

PURPOSE: This study was performed to determine the involvement of joints by screws, inserted on the anterior process of the calcaneus, using cadaveric specimens. MATERIALS AND METHODS: An L-shaped lateral incision was performed on 32 embalmed feet (16 cadavers). An H-plate was applied on lateral wall of the calcaneus and it's anterior margin was located at 4 mm posterior to the lateral margin of the calcaneocuboidal joint. 3.5 mm cortical screws were inserted perpendicularly to the lateral calcaneal wall through the plate. Each calcaneus was dissected and taken out from the foot, and whether the tips of screws penetrated joints on the anterior process was evaluated. RESULTS: 11 (17.2%) of 64 screws, inserted on the anterior process, penetrated joints. Among them, seven screws involved the calcaneocuboidal joint and four screws penetrated the anterior facet of the subtalar joint. In two cases, both joints were penetrated by screws. CONCLUSION: This study shows that joint surfaces could be penetrated by screws inserted from the lateral surface on the anterior process of the calcaneus. Care should be given to selecting the length and insertional angle of screws. Intraoperative radiography would be needed to observe the articular surface on the anterior process, when screws were inserted to the anterior process close to the calcaneocuboidal joint.
Cadaver ; Calcaneus ; Foot ; Joints* ; Radiography ; Subtalar Joint

PURPOSE: We investigated the prevalence rate of benign prostatic hyperplasia (BPH) among Korean males in a rural area through a cross-sectional, community-based epidemiologic survey and analyzed the correlation with epidemiologic factors. MATERIALS AND METHODS: A total of 779 males who lived in Yangpyeong County participated in a prostate examination campaign. Targeting these men, we collected the International Prostate Symptom Score (IPSS), medical history, demographic information, serum prostate-specific antigen, and prostate volume as measured by transrectal ultrasonography. The data for 599 participants were analyzed, excluding 180 men who had a possibility of prostate cancer. BPH was defined as an IPSS of 8 points or higher and a prostate volume of 25 mL or more. RESULTS: The prevalence rate of BPH was 20.0%. The prevalence rate increased with age. There were 2 subjects (4.4%) in the age group of 40-49 years, 18 subjects (10.9%) in the age group of 50-59 years, 44 subjects (22%) in the age group of 60-69 years, and 56 subjects (26.6%) in the age group of over 70 years; this increase with age was statistically significant (p<0.001). In the BPH group, the average IPSS was 14.67+/-5.95, the average prostate volume was 37.04+/-11.71 g, and the average prostate-specific antigen value was 1.56+/-0.88 ng/mL. In the analysis of correlations between the epidemiologic factors and the risk of BPH, smoking was the only statistically significant factor. CONCLUSIONS: The total prevalence rate of BPH in this study was 20.0%, which was a little lower than the rate reported in other cities or rural areas.
Adult ; Age Distribution ; Aged ; Community-Based Participatory Research ; Cross-Sectional Studies ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prevalence ; Prostate/ultrasonography ; Prostate-Specific Antigen/blood ; Prostatic Hyperplasia/*epidemiology ; Republic of Korea/epidemiology ; Rural Population/statistics & numerical data ; Smoking/adverse effects

PURPOSE: Paroxysmal non-epileptic event (PNE) is a common seizure-like symptom in children. With regard to therapy, a decrease in iron levels was reported in breath-holding spells, but not in other PNEs. The effects of iron supplementation were investigated on various PNEs. METHODS: Medical records of patients who visited our clinic with seizure-like symptoms were retrospectively reviewed at Chungnam National University Hospital, from March 2013 to March 2016. RESULTS: A total of 29 patients (65.9%) were boys and 15 (34.1%) were girls. The mean gestational age and birth weight were 39.3 weeks and 3,200 g, respectively. The mean age at the time of visit was 23.5 months. Of the 11 patients who underwent brain imaging, 10 (90.9%) had normal findings and 1 (9.1%) had subdural hemorrhage. An electroencephalogram was performed in 29 patients; 26 of them had normal findings (89.7%), 2 (6.9%) had slow background, and 1 (3.4%) had epileptiform discharges. A total of 31 patients (70.5%) had iron levels lower than 80 µg/dL. Iron supplementation was administered in 4 of the 13 patients with normal iron status and in 21 of the 31 patients with low iron status. A significant improvement in the frequency and severity of symptom was observed in 91.7% of patients who received iron supplementation (P<0.05). CONCLUSIONS: Symptoms improved in 80% of patients with PNE, and a higher rate of symptom improvement could be expected with iron supplementation.
Birth Weight ; Child* ; Chungcheongnam-do ; Electroencephalography ; Female ; Gestational Age ; Hematoma, Subdural ; Humans ; Infant ; Infant Behavior ; Infant, Newborn ; Iron* ; Medical Records ; Neuroimaging ; Retrospective Studies ; Seizures

We aimed to compare the clinical outcomes of knee osteoarthritis patients according to drug adherence; and to find out the factors the affecting those outcomes. We analyzed the drug adherence and clinical outcomes in 1,334 primary knee osteoarthritis patients who took non-steroidal anti-inflammatory drugs (NSAIDs) for 3 weeks. Clinical outcomes of Pain Numeric Rating Scale (NRS), Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-5D were compared at baseline and 3 weeks' follow-up between the two groups of adherent group and non-adherent group (1,167 vs. 167 patients). Logistic regression analysis was performed to examine the factors affecting the adherence, and the reasons for the non-adherence were asked. The follow-up clinical outcomes of NRS and KOOS symptom, pain and activity of daily life were significantly higher in the adherence group (P = 0.003, P = 0.048, P = 0.005, and P = 0.003, respectively). The adherence was better in the elderly and in the male group (P = 0.042 and P = 0.034, respectively) and the top reason for no strict adherence was "symptom improved" (21.5%) followed by side effects. In this study, the patients with better adherence to NSAIDs showed better outcomes compared to those with poor adherence. This study can contribute to the patient education for the pharmacological treatment in knee OA patients.
Age Factors ; Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use ; Female ; Humans ; Knee Joint/pathology ; Logistic Models ; Male ; *Medication Adherence ; Osteoarthritis, Knee/*drug therapy ; Pain Measurement ; Prospective Studies ; Sex Factors

BACKGROUND: To evaluate airway responses and inflammation to antigen in Sprague-Dawley rat asthma model, we examined airway responses, serial histologic changes of the lung, and the relationship between airway responses and airway inflammation after antigen airway challenge. METHODS: Sprague-Dawley rats were sensitized with subcutaneous injection of 10 microgram ovalbumin(OA). Antigen airway challenges were done 14 ~16 days after sensitization and the sensitized rats were sacrificed 1h(AE), 6 ~8h(AL) and 1day(AD) after airway challenge, to examine the histologic changes of the lung. Airway responses were measured by body plethysmograph and recorded by enhanced pause(Penh) as an index of airway obstruction 6 ~8h after antigen challenges. Nonsensitized controls(10 rats) were also challenged with antigen and sacrificed 1 day later. Histopathologic examination of two trachea, large bronchi, small bronchi, and vessels was performed to evaluate the severity of inflammation and eosinophilic infiltration with H&E stain. RESULTS: In 17 of 20 rats(85%) in both groups, we observed airway responses. Among them, an early response(ER) in 15 rats(75%), an dual response in 5(25%), and an late response(LR) only in 2 rats(10%) displayed. There were no significant differences in the severity of inflammation among the trachea, large bronchi, small bronchi and vessels in all groups after antigen challenge(p>0.05) and between early and late responders. The significant eosinophil infiltration was observed in 5 rats(50%) of AL(p<0.05) compared with in AE and controls. Also, eosinophil infiltration was observed in higher trend in LR(57.1%) compared to ER(40%)(p>0.05). CONCLUSION: Sprague-Dawley rats sensitized with subcutaneous injection of OA showed a significant airway responses to antigen challenge. But antigen challenges caused a little eosinophil infiltration and no significant airway inflammation. Asthma model of Sprague-Dawley rats could be useful for antigen-induced airway responses, but this model has a limitation for the study of human asthma because of no significant pathologic change.
Airway Obstruction ; Animals ; Asthma* ; Bronchi ; Eosinophils ; Humans ; Inflammation* ; Injections, Subcutaneous ; Lung ; Ovalbumin* ; Rats ; Rats, Sprague-Dawley* ; Trachea

PURPOSE: Headache is a common symptom during childhood. It is usually persistent and requires special care. This study aimed to identify the characteristics of headache in children < 7 years of age. METHODS: We reviewed 3 years of clinical files on children < 7 years of age with a chief complaint of headache. RESULTS: This study included 146 children (66 males, 80 females; mean age, 5.5±1.0 years). Mean symptom duration was 5.8±7.9 months. Attack durations were longer than 2 hours in 31 patients, shorter than 2 hours in 70 patients, and unchecked in 45 patients. Attack frequency was 15.1±10.6 times per month. Pain locations and characteristics were also variable. Mean pain severity score was 5.1±2.2 on the visual analog scale. Of 38 patients who underwent electroencephalography, 9 showed positive findings. Of 41 who underwent brain magnetic resonance imaging, 20 showed positive findings. The diagnoses were migraine (including probable migraine) in 34, tension-type headache in 5, and congenital malformations in 3. Medications were used in 29 patients: acetaminophen in 17, ibuprofen in 8, naproxen sodium in 1, and topiramate or amitriptyline in 3. CONCLUSION: In children aged < 7 years, headache has a relatively benign course, but detailed history taking is needed for more accurate diagnosis.
Acetaminophen ; Amitriptyline ; Brain ; Child* ; Diagnosis ; Electroencephalography ; Female ; Headache* ; Humans ; Ibuprofen ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Naproxen ; Tension-Type Headache ; Visual Analog Scale